• Title/Summary/Keyword: 치과적 합병증

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Flexible IARPD considering the prevention of combination syndrome: a case report (Combination syndrome 예방을 고려한 flexible IARPD 증례)

  • Kim, So-yeun
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.347-353
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    • 2022
  • Traditional denture treatment is often performed in patients with the completely edentulous maxilla and the bilateral edentulous posterior mandible. However, with a long-term prognosis, a complication called 'combination syndrome' may occur in this oral environment. In this case, by applying an implant-assisted removable partial denture (IARPD), it is possible to preserve the alveolar bone and prevent combination syndrome. In this case, when additional implants are placed in the edentulous area, the stress applied to the abutment due to the movement of the removable denture can be reduced, so it is possible to design an esthetic clasp using resin rather than metal, and flexible denture base resin is used. As a treatment for maxillary complete denture and mandibular flexible IARPD, it showed an esthetic and functional long-term prognosis with minimal cost and surgery.

Retrospective study on three-dimensional characteristics of mesiodens using CBCT in pediatric dentistry (치과용 Cone-beam CT를 이용한 상악 정중과잉치의 3차원적 특성에 관한 후향적 연구)

  • Ryu, GiYoun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.1
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    • pp.77-94
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    • 2021
  • The purpose of this study was to investigate the three-dimensional characteristics of mesiodens using Cone-beam Computed Tomography(CBCT) and analyze the factors affecting complications and anesthetic methods of extraction. This study evaluated 602 mesiodens of 452 patients who underwent extraction of mesiodens at the department of Pediatric Dentistry in Seoul National University Dental Hospital between 2017 and 2019. The ratio of mesiodens patients over total patient per year was gradually increased over the past 20 years. Mesiodens with labio-palatally horizontal direction while root directing labial were the most common among the mesiodens with horizontal direction. Mesiodens were the most common at the cervical side of the adjacent teeth(37.0%) and mesiodens located in the near-palatal side were observed about 3.83 times higher than the far-palatal side. Most of the mesiodens(82.1%) were in contact with adjacent permanent teeth on all three sides of the CBCT and 46.2% of mesiodens had curved roots. The patient's age, vertical position, presence of complications, and proximity showed a significant difference in the selection of general anesthesia among anesthetic methods. The direction and vertical position of mesiodens had a significant effect on complications. These results provide a better understanding of mesiodens for establishing an accurate diagnosis and treatment plan.

INFECTIVE ENDOCARDITIS IN ANTIBIOTICALLY PROTECTED PATIENT WITH VENTRICULAR SEPTAL DEFECT (심실 중격 결손에 의한 감염성 심내막염 환자의 치과치료)

  • Yang, Jung-Hyun;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Lee, Sang-Hoon;Hahn, Se-Hyun;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.461-467
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    • 2007
  • Infective endocarditis is a life-threatening disease, although it is relatively uncommon. Substantial morbidity and mortality result from this infection. Therefore, primary prevention of endocarditis whenever possible is very important. The American Heart Association updated recommendations for the prevention of infective endocarditis in individuals at risk for this disease in 1997. But, utilization of antibiotic prophylaxis for patients at risk does not provide absolute immunity from infection. This report presents the case of infective endocarditis that occurred in spite of appropriate antibiotic prophylaxis in the ventricular septal defect(VSD) patient.

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Evaluation of clinical status of fixed prosthesis (고정성 보철물의 임상적 상태에 대한 평가)

  • Yun, Mi-Jung;Jeon, Young-Chan;Jeong, Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.99-107
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    • 2009
  • Statement of problem: Restoring and replacing teeth with fixed prostheses commonly used in dental practice. Because of improper oral hygiene care and inaccurate laboratory procedure, complications of fixed prostheses were found in the mouth of patients. Although many efforts have been continually made to obtain the data of long term prognosis of fixed prostheses, it was difficult to do it. Purpose: The purpose of this study was to evaluate the clinical status of fixed prostheses. Material and methods: In order to assess the clinical status of fixed prostheses, a total of 161 individuals(aged 17-85, 99 women and 62 men with 1596 unit of fixed prostheses, and 1169 abutments) who first visited the Department of Prosthodontics, Pusan National University Hospital, between April to September, in 2007 were examined. Results and conclusion: The results of this study were as follows: 1. Length of service of fixed prostheses was $8.6{\pm}0.6$ years(mean), 10.0 years(median). 2. Location of fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in posterior region and in mandible where the failure rate was high in combination(P<.05). 3. Longevity of fixed prostheses made of metal was longest(mean: $13.0{\pm}9.3$, median: 14.0), gold, precious ceramic, non-precious ceramic trailing behind(P<.05). 4. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in Single-unit and the failure rate was high in over 3-unit(P<.05). 5. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses(P>.05). But, the success rate was high in natural dentition(P<.05). 6. Defective margin(28.2%), dental caries(23.0%), periodontal disease(19.3%), periapical disease(16.9%) were frequent complications. In 30.1% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

Dental Management in a Patient with Turner Syndrome with Dental Anomalies : A Case Report (치아형태이상을 가진 터너 증후군 환자의 치과적 관리)

  • Lee, Haney;Shin, Seyoung;Kim, Jaegon;Lee, Daewoo;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.3
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    • pp.386-392
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    • 2018
  • Turner syndrome (TS) is a chromosomal disorder caused by monosomy of the X chromosome, with complete or partial absence of the second sex chromosome. Anomalies of root morphology have been found to occur more often in patients with TS, which make endodontic treatment challenging and requires special handling. The patients with TS may also have systematic problems such as cardiac or renal malformations, so in treating these patients it is important for clinicians not only to be aware of the characteristic intraoral findings, but also to make the patients have regular dental check-ups to prevent oral complications in advance. An 12-year-old girl who had been diagnosed with TS at the age of 10 years was referred due to discomfort in the bilateral mandibular premolar regions. Dens evaginatus and taurodontism were detected in all the mandibular premolars characteristically. The bilateral mandibular first premolars had three roots and the bilateral mandibular second premolars had periapical lesion with two roots. Due to the complexity of the root canal anatomy, root canal treatment were completed with a dental microscope to ensure adequate visualization. After 2 years of regular follow-up examinations, there were no clinical sign or symptom associated with the teeth, and no periapical lesion, was found. This case report describes the characteristic oral features and dental management of TS patients.

THREE-DIMENSIONAL EVALUATION OF IMPACTED MAXILLARY CANINES USING CONE BEAM COMPUTED TOMOGRAPHY AND PANORAMIC RADIOGRAPHS (Cone beam CT와 파노라마방사선사진을 이용한 매복 상악 견치의 3차원적 분석)

  • Jeon, Sang-Yun;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.2
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    • pp.106-117
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    • 2013
  • Normal eruption of the canine is important for the transition to the permanent dentition. Etiologies, including premature loss or delayed retention of deciduous teeth, neoplasm and abnormality of lateral incisor can cause impaction of the maxillary canine. Untreated canine impaction can result in malocclusion, cyst formation and obstacles in orthodontic treatment. The aim of this study is to evaluate location of the impacted maxillary canine and to identify correlation between location and management of the impaction including complications. Using panoramic radiographs and CBCT scan, images of 89 children diagnosed with impaction of the maxillary canine, location of impacted canines was evaluated. The choice of treatment and complications were investigated to identify correlation. Results show that the most commonly impacted location of the maxillary canine was in the mid-alveolar area, followed by buccal side and palatal side. Orthodontic traction was selected more frequently than the other treatments. As complications, displacement of adjacent tooth was occurred most frequently. Buccally impacted canines showed increased tendency towards displacement. The more buccally the canine was impacted, the less orthodontic traction was chosen as the treatment. The canine impacted mesially to the central incisor showed increased tendency to occur root resorption. Therefore, early diagnosis by periodic examination, appropriate treatment and intervention is required.

Dental implant failures and complications - Retrospective study (치과 임플란트 실패와 합병증의 후향적 연구)

  • Park, Ju-Hee;Jo, Chan Woo;Woo, Jae-Man;Kahm, Se Hoon
    • The Journal of the Korean dental association
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    • v.57 no.7
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    • pp.372-378
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    • 2019
  • The dental implants in modern dentistry brought out a new era in everyday dental practice. Increasing of dental implants usage, various failures and complications has occurred. Failures and complications of dental implant treatments that can happen in implant surgery, in mechanical or prosthetic problem and in biological aspect. The aim of this study was to assess implant failures for 6 years as well as find out how to overcome implant failure. In Jeju National University hospital, 26 dental implants in 17 patients were removed by implant failure through 2013.1.1.-2018.12.31. Each implant failure case was analyzed in report form with various informations about failure retrospectively. The present study showed 26 failed dental implants of 17 patients were removed. 13 implants(50%) of 8 patients(47.06%) were failed before functional loading and 13 implants(50%) of 9 patients(52.94%) were failed after functional loading. 11 implants(42.31%) of 7 patients(41.18%) with medical disease were extracted. 6 implants(23.08%) of 5 patients(29.41%) with additive bone graft were failed. We discuss with 26 failed dental implants of 17 patients about their causes, solutions and prevention retrospectively for 6 past years. Precise diagnosis and treatment planning are needed. Medically compromised patients and patients with implants and additive bone grafts should be cautiously treated with high failing possibilities.

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Syncope and pneumomediastinum during the maxillary sinus elevation with an air-syringe: a case report (주사기를 이용한 상악동 거상술 시 발생한 실신 및 종격동기종에 관한 증례보고)

  • Kim, Su Wan;Lee, Jonggeun;Song, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.3
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    • pp.171-176
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    • 2021
  • Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.

DENTAL MANAGEMENT OF A PATIENT WITH MUSCULAR DYSTROPHY UNDER GENERAL ANESTHESIA: CASE REPORT (근이영양증(muscular dystrophy) 환자의 전신마취 하 치과치료 : 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.50-54
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    • 2019
  • Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.

ROOT MALFORMATION OF PERMANENT INCISORS BY ALVEOLAR BONE FRACTURE (치조골 골절을 동반한 유치열기 외상에 의한 영구절치의 치근 형성 이상)

  • Ji, Eun-Hye;Choi, Hyung-Jun;Choi, Byung-Jai;Son, Heung-Kyu;Kim, Seung-Hye;Song, Je-Seon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.290-295
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    • 2011
  • During tooth formation, tooth development can be affected by physical action or metabolic changes around dental follicle. Especially trauma to primary dentition is the most representative physical factor that can cause development disorders of succedaneous tooth. Enamel hypoplasia and crown discoloration of succedaneous tooth are common complications of trauma. And impaction, ectopic eruption, arrest of root formation and root dilaceration of succedaneous tooth are rare. In this case, a 6-year and 5-month-old female patient visited for dental evaluation after trauma. She was diagnosed with alveolar bone fracture near upper front teeth, extrusion of the upper right and left primary central incisors, intrusion of the upper right primary lateral incisor, and palatal luxation of the upper left primary lateral incisor. Upper right and left primary central incisors with severe mobility were extracted, with gingival suture on the day of the visit. During 24 months check up, root dilacerations were found near the cemento enamel junction in the upper lateral incisors and arrests of root formation were found on the coronal 1/3 of the root in the upper central incisors. Although alveolar bone fracture is rare type of trauma in children, a thorough examination of alveolar bone is essential for prognosis and following treatment in patients with trauma.